Comparison of clinical outcomes between first-generation and second-generation drug-eluting stents in type 2 diabetic patients

2013 ◽  
pp. 1
Author(s):  
Han Saem Jeong ◽  
Jae Young Cho ◽  
Eun Ji Kim ◽  
Cheol Woong Yu ◽  
Chul-Min Ahn ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
First Generation ◽  
Second Generation ◽  
Drug Eluting Stents ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Drug Eluting ◽  
Type 2 Diabetic

scholarly journals Impact of coronary collateralization on long-term clinical outcomes in type 2 diabetic patients after successful recanalization of chronic total occlusion

2020 ◽  
Author(s):  
Zhen Kun Yang ◽  
Ying Shen ◽  
Yang Dai ◽  
Xiao Qun Wang ◽  
Jian Hu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Total Occlusion ◽  
Repeat Revascularization ◽  
Type 2 Diabetic

Abstract Background: To assess the prognostic role of coronary collaterals in patients with type 2 diabetes mellitus (T2DM) after successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Methods: Coronary collateralization was graded according to Rentrop scoring system in 198 type 2 diabetic patients and 335 non-diabetics with stable angina undergoing PCI for at least one CTO lesion. Left ventricular ejection fraction (LVEF) was determined and major adverse cardio-cerebral events (MACCE) were recorded during follow-up. Results: Poor collateralization was more common in patients with T2DM than in non-diabetics (40% vs 29%, p=0.008). At 13.5±4.1 months, the rate of composite MACCE (17.3% vs 27.6%, p=0.034) and repeat revascularization (15.2% vs 25.5%, p=0.026) was lower and the increase in LVEF (3.10 % vs 1.80%, p=0.024) was greater in patients with good collaterals than in those with poor collaterals for non-diabetic group, but did not differ for T2DM group (35% vs 44%; 30% vs 36%; 2.14% vs 1.65%, respectively, all p>0.05) except for a higher all-cause mortality in diabetic patients with poor collaterals (p=0.034). Multivariable Cox proportional hazards analysis showed that coronary collateralization was an independent factor for time to MACCE (HR 2.155，95%CI 1.290-3.599, P=0.003) and repeat revascularization (HR 2.326, 95%CI 1.357-3.986, p=0.002) in non-diabetic patients, but did not enter the model in those with T2DM. Conclusions: T2DM is associated with reduced coronary collateralization. Successful revascularization of CTO lesions results in a mild improvement in left ventricular function, but t he status of coronary collaterals has no independent effect on long-term clinical outcomes in patients with T2DM.

scholarly journals Comparison of Clinical Outcomes Between Second-and First-Generation Drug-Eluting Stents in Patients With Chronic Total Occlusion Lesion: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuan Qiao ◽  
Wen-Jiao Zhang ◽  
Wen-Fen Guo ◽  
Yan Li ◽  
Xi-Ying Liang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Chronic Total Occlusion ◽  
First Generation ◽  
Second Generation ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Total Occlusion ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background and Objectives: The second-generation drug-eluting stents have been used to treat chronic total occlusion lesion. However, there is limited evidence of the clinical outcomes that whether the second-generation drug-eluting stents is superior to first-generation ones in patients with chronic total occlusion lesion undergoing percutaneous coronary intervention. The study aimed to compare the differences in clinical outcomes between the two generations drug-eluting stents in patients with those by a meta-analysis.Methods: PubMed, Embase, the Cochrane library and Web of science databases were systemically searched before March, 2021. Randomized controlled trials and observational studies were included to compare the second-generation drug-eluting stents with the first-generation ones in patients with chronic total occlusion lesion undergoing percutaneous coronary intervention. The clinical outcomes were major adverse cardiac events (MACE), target vessel revascularization, myocardial infarction, all-cause death. Fixed effects models were used to calculate the odds ratio (OR) and 95% confidence interval (CI) of each clinical outcome. Sensitivity analysis was performed to detect potential sources of heterogeneity. Subgroup analyses were used to assess the differential effects.Results: The meta-analysis included eight studies involving 4,583 patients with chronic total occlusion lesion undergoing percutaneous coronary intervention. Pooled analysis showed that the incidence of MACE (OR = 0.68, 95%CI 0.54–0.85, P = 0.0008), target vessel revascularization (OR = 0.70, 95%CI 0.54–0.91, P = 0.007), and myocardial infarction (OR = 0.58, 95%CI 0.37–0.93, P = 0.02) were lower in the second-generation drug-eluting stents compared with the first-generation ones. However, there was not difference in all-cause deaths between two drug-eluting stents (OR = 0.67, 95%CI 0.45–1.01, P = 0.05).Conclusions: The second-generation drug-eluting stents are associated with lower MACE, target vessel revascularization, and myocardial infarction compared with the first-generation ones in patients with chronic total occlusion lesion undergoing percutaneous coronary intervention. The results of this study can provide a reference for the selection of stents in patients with chronic total occlusion lesion. Further randomized controlled trials are needed to verify that the second-generation drug-eluting stents is superior to the first-generation ones in patients with chronic total occlusion (Registered by PROSPERO, CRD42020158406).

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